Background: Information, communication and participation between health professionals and patients is a central element in the person-centered care. Great part of the health damages are related to communications failures.  Aim: The aim of the study was to investigate and describe hospitalized patients' experiences of information, communication and participation of their health, care and treatment.  Method: Quantitative non-exprimental cross-sectional study with descriptive design with qualitative elements. Participants were 36 patients hospitalized in a hospital in southern Sweden on medicine, surgeon, orthopedic, stroke or infection departments. The data collection took place in one week's time with the help of a survey. Data were analyzed with descriptive statistics.  Results: High results were shown for the total responses for requests for information, communication and participation. No significant differences were found between acute patients and elective. In the comparison between men and women´s experience, a significant difference was detected in terms of information on possible delays and if it was given enough privacy when the staff talked about his or her medical/health condition or care/treatment. For both questions, men estimated higher results. Conclusion: Positive results of the participants' perception of information, communication and participation regarding their health, care and treatment. To follow the developments that have occurred and still occurs on person-centered care need further research be done to ensure that patients understand the information communicated and feel involved in their care and treatment. / Bakgrund: Information, kommunikation och delaktighet mellan vårdpersonal och patienter är en central del inom den personcentrerade vården. Stor del av vårdskadorna är relaterade till kommunikationsbrister.   Syfte: Syftet med studien var att undersöka och beskriva inneliggande patienters upplevelser av information, kommunikation och delaktighet om sitt hälsotillstånd, vård och behandling. Metod: Kvantitativ icke-exprimentell tvärsnittsstudie med deskriptiv design med kvalitativa inslag. Deltagarna var 36 patienter inneliggande på sjukhus i södra Sverige på medicin, kirurg, ortoped, stroke eller infektionsavdelning. Datainsamlingen skedde under 1 veckas tid med hjälp av en enkät. Data analyserades med deskriptiv statistik. Resultat: Höga resultat visades för de samlade svaren för frågor rörande information, kommunikation och delaktighet. Inga signifikanta skillnader påvisades mellan akut inlagda patienter och elektiva. I jämförelse mellan män och kvinnors upplevelse kan en signifikant skillnad påvisas i fråga om information vid eventuell försening samt ifall det gavs tillräckligt med avskildhet när personalen pratade om dennes sjukdom/hälsotillstånd eller vård/behandling vid båda resultaten skattar män sin upplevelse högre än kvinnorna. Slutsats: Positiva resultat av deltagarnas uppfattning av information, kommunikation och delaktighet rörande sitt hälsotillstånd, vård och behandling. För att följa den utveckling som har skett och fortfarande sker mot personcentrerad vård måste vidare forskning ske för att patienterna ska förstå den information som kommuniceras och känna delaktighet i sin vård och behandling.

Bakgrund: Trots att hälso-och sjukvården varit framgångsrik i att behandla hjärt-och kärlsjukdomar de senaste decennierna, utgör kardiovaskulära sjukdomar fortfarande den vanligaste dödsorsaken i Sverige. Samtidigt visar forskningen att mellan en tredjedel till hälften av patienterna inte följer den ordinerade behandlingen som syftar till att minska riskfaktorerna eller behandla symptom. Låg följsamhet är därmed en ofta förbisedd riskfaktor som leder till försämrad hälsa, ökad vårdtyngd och ökade kostnader för vården. Syfte: Att belysa vilka faktorer som påverkar patienters följsamhet till behandling vid hjärtkärlsjukdom. Metod: Studien utformades som en allmän litteraturstudie, med empirin hämtad från Databaserna CINAHL och PubMed. Tio artiklar valdes ut och granskades med hjälp av SBU:s granskningsmall för kvalitativa studier. Analysen gjordes sedan genom en enkel innehållsanalys. Resultat: Det framkom två teman, sex kategorier och 14 underkategorier som på olika sätt beskrev faktorer till följsamhet. Faktorerna delades upp i inre faktorer som rörde patienters tankar, känslor och handlingar, samt yttre faktorer som rörde de aspekter som påverkade patienterna utifrån. Slutsats: Resultatet visade att patienters redogörelser för faktorer till följsamhet var flera och komplexa. En stor del av faktorerna låg bortom patientens kontroll, bland annat visade det sig att relationen mellan vårdare och patient var betydelsefull. Vidare visade resultatet att faktorerna uppvisade en variation mellan patienter, således är det väsentligt att sjuksköterskor arbetar personcentrerat för att kunna optimera patienters följsamhet. / Background: Although health care has been successful in treating cardiovascular diseases in recent decades, cardiovascular disease still remains the most common cause of death in Sweden. Simultaneously, research shows that approximately one third to half of the patients do not follow the prescribed treatment, aimed at reducing the risk factors or treating symptoms. Therefore, low adherence is a frequently overlooked risk factor which ultimately leads to impaired health, increased healthcare strain and increased costs. Purpose: To highlight the factors affecting patients’ adherence to cardiovascular disease treatment. Method: The study was designed as a literature review, with studies gathered from the CINAHL and PubMed databases. Ten qualitative articles were selected and examined using the SBU's qualitative study review template. The analysis was then conducted using content analysis. Findings: Two themes, six categories and 14 subcategories which in different ways describe factors that influence patient adherence emerged during the analysis. The factors were divided into inward factors, concerning patient thoughts, emotions and actions, and outward factors concerning external factors that influenced the patient. Conclusion: The results showed factors to adherence were numerous and complex. A large proportion of the factors were beyond the control of the patient, and the relationship between carers and patients proved significant. Furthermore, the results displayed that the factors showed a variation between patients, therefore it is essential that nurses work person-centered to optimize patients’ adherence.

Bakgrund: Demens är en av de stora folksjukdomarna i världen och med en ökad medellivslängd insjuknar fler och fler människor varje år. Demens är en kronisk kognitiv sjukdom som resulterar i psykiska-, fysiska- och motoriska symtom. Hanteringen av dessa symtom är komplext och kan förse personal, närstående och patienter med stora utmaningar. Farmakologisk behandling av demens är kontroversiellt med begränsad effekt och kan innebära starka biverkningar. Icke-farmakologiska behandlingsmetoder är få och underutnyttjade. Syfte: Att sammanställa vårdpersonalens upplevelser av musik som omvårdnadsåtgärd vid demenssjukdom. Metod: Litteraturstudien är uppbyggd på tio vetenskapliga artiklar med kvalitativ ansats. Databaserna innefattar Cinahl, PubMed och PsycINFO. Analysen av valda artiklar är baserad på Forsberg och Wengströms analysmetod för kvalitativ innehållsanalys samt kvalitetsgranskades med SBU:s kvalitetsgranskningsmall. Resultat: I analysprocessen formulerades tre övergripande huvudkategorier, vilka var musikens inverkan på symtom vid demens, musik och känslan av meningsfullhet samt musikens inverkan på kommunikationen. Resultatet visade att musik i olika former upplevdes ha positiv inverkan på patienters agitation, oro, kommunikation, minnen och fysiska färdigheter vilket upplevdes ge patienterna en känsla av meningsfullhet. Patienternas ökade kommunikationsförmåga och ändrade beteende genererade en positiv inverkan på organisatoriska faktorer och miljön på avdelningarna. Vidare sågs det finnas ett fåtal negativa aspekter kring musik som främst handlade om bristande intresse hos personal samt svårigheter i planering av utförande. Slutsats: Det visade sig att vårdpersonalen framförallt ansåg att musik var ett positivt redskap vid omvårdnad av demenssjukdom. / Background: Dementia is one of the main widespread diseases in the world and with an increased life expectancy, more and more people are diagnosed every year. Dementia is a chronic cognitive disorder that results in mental-, physical- and motor symptoms. The management of these symptoms are complex and can present great challenges to staff, relatives and patients alike. Pharmacological treatment of dementia is controversial with limited efficiency and may result in strong side effects. Non-pharmacological treatments are few and underutilized. Purpose: To compile the care staff’s experience of music as a nursing strategy in dementia care. Method: The literature study is based on ten scientific articles with a qualitative approach. The databases used include Cinahl, PubMed and PsycINFO. The analysis of the selected articles was based on Forsberg and Wengströms method of analysis for qualitative content and was quality checked with SBU: s qualitative review template. Result: The analysis process generated three main categories, which were experience of music’s impact on dementia symptoms, music and the sense of meaningfulness and music’s impact on communication. The results showed that music in different forms had a positive impact on patients’ agitation, anxiety, communication, memory and physical skills, which care staff thought gave the patients a sense of meaningfulness. The patients’ changed behaviors generated a positive impact on organizational factors and the environment of the departments. Furthermore, the results showed a few negative aspects, that mainly revolved around a lack of interests from care staff as well as difficulties in planning. Conclusion: Too summarize, the care staff found music to be a positive nursing tool in dementia care.

Background: The number of people suffering from myocardial infarction in Sweden is decreasing, despite this the prevalence is high. Being diagnosed with myocardial infarction results in medical interventions, lifestyle changes and eventual pharmacological treatment to prevent relapse. Aim: The aim of this study was to describe patients' experience of life after amyocardial infarction. Method: A literature-based study was used, based on ten qualitative articles. The articles were analyzed in a five step-model, which resulted in three main-themes and sixsub-themes. Results: The results present life after myocardial infarction as difficult to understandand manage. This could be related to their physical and mental changes, which resulted in fear and anxiety that affected their everyday lives through experienced limitations. Fatigue where also a contributing factor in the limitations of everyday life due to energyloss. This was hard to handle without support from both relatives and health care professionals. It was essential to be meet as a unique human and not reduced to a diagnosis. Life became more valuable through the survival and gave the individuals a second chance with different priorities. Some adjusted to the lifestyle changes, while others were reluctant. Returning to work where seen as an indicator for being healthy and a return to life as before. Conclusion: To establish well-being and security through nursing, a holistic approach that is the basis of person-centered care helps nurses to see the individual situation. / I Sverige minskar antalet personer som drabbas av hjärtinfarkt trots detta är förekomsten fortfarande hög och ca 5800 avlider varje år. Hjärtinfarkten medför både fysiska och psykiska förändringar hos den drabbade. Syftet med denna litteraturstudie är att belysa patienters upplevelse av livet efter en genomgången hjärtinfarkt. I studiens resultat framkom det att både män och kvinnor såg situationen och livet efter en hjärtinfarkt som svår att hantera, då både kroppen och hjärtat inte längre upplevdes pålitligt. Detta resulterade i rädsla och oro som begränsade det vardagliga livet. Personerna upplevde att det var svårt att tolka kroppsliga signaler, vilket gav en osäkerhet som resulterade i ångest och katastrof tankar om döden. Detta medförde även att de inte vågade anstränga sig fysiskt. Känslor som ilska, frustration och nedstämdhet upplevdes på grund av den mentala och fysiska utmattningen som var svår att förstå. Personerna kunde inte utföra vardagsaktiviteter i samma utsträckning som innan hjärtinfarkten, vilket resulterade i en känsla av passivitet. Det utrycktes även ett behovav stöd från anhöriga och vårdpersonal för att klara av sin situation och det vardagligalivet. Vårdpersonalens bemötande och agerande var avgörande för hur patienterna förstod informationen som gavs, deltog i rehabilitering och klarade att genomföra nödvändiga förändringar när det gäller ohälsosamma levnadsvanor. Vårdpersonalens förmåga att skapa en trygg atmosfär tillsammans med att se patienten som människa var viktigt för att uppnå välbefinnande. Anhöriga sågs som en resurs för personerna då de kunde avlasta vardagssysslorna samtidigt som de lyssnade, vilket gav trygghet och välbefinnande hemma. Patienter upplevde att familjen satt för höga krav och fick då stödet från vänner. Partnerrelationen kunde påverkas genom den minskade sexuella relationen som grundade sig i rädsla för de fysiska förändringarna och upplevdes svårt att prata om med partnern. Livet efter en hjärtinfarkt beskrevs som en ny chans till livet där nya värderingar uppstod. Personerna upplevde att arbetsgivarens attityd och förståelse för situationen var avgörande för fortsatt sjukskrivning. För att kunna möta patientens unika behov och skapa välbefinnande genom omvårdnad, är personcentrerat förhållningssätt lämpligt för att vidhålla en helhetssyn på patienten och inte bara det fysiologiska tillståndet.

Bakgrund HBTQI-personer står för samma hälsoproblematik som övriga befolkningen. Däremot löper de större risk för depression, suicidalitet och ohälsa, såsom bröstcancer, analcancer och övervikt. Inom denna grupp används även beroendeframkallande substanser i högre grad. HBTQI-personer utsätts för sociala påfrestningar vilket påverkar det dagliga livet. Den osynlighet HBTQI-personer har i vården påverkar utkomsten av den medan vårdpersonal samtidigt uttrycker att okunskap finns för HBTQI-specificerad vård. Syfte Syftet var att belysa HBTQI-personers upplevelser av mötet med vården inom somatisk vård. Metod Denna icke-systematisk litteraturöversikt är utförd med en kvalitativ design där 15 vetenskapliga artiklar inkluderats. Sökordskombinationer i databaserna CINAHL och Pubmed användes för att inhämta artiklarna. Artiklarna kvalitetsgranskades utifrån ett bedömningsinstrument för att sedan genomgå en analys. I analysen skapades teman och subteman baserat på de olika artiklarnas resultat. Resulta tHBTQI-personer upplevde främst negativa upplevelser av vårdmötet. Heteronormativitet, bristande kunskaper i HBTQI-specifik vård och vårdkvalitet samt en oförmåga att bilda en tillitsfull relation till vårdgivaren var orsakerna till detta. Framgångsfaktorer i vårdmöte tvar när HBTQI-personer upplevde en personcentrerad vård där kommunikation, respekt, öppenhet, intresse och medkänsla upplevdes. Slutsats Samtliga artiklar påvisade negativa upplevelser av vårdmötet som övervägande. En utökad kunskap hos vårdpersonalen i HBTQI-specifik vård skulle kunna utmana de negativa upplevelserna HBTQI-personer upplever samt bjuda in till en mer välkomnande vård där kvalitet och kunskap finns men också en god kommunikation med öppenhet och intresse.

Shared decision-making (SDM) for contraceptive counseling and method initiation is a hallmark of patient-centered care; SDM is associated with patient satisfaction, method continuation, and the prevention of pregnancy and short inter-pregnancy intervals. To achieve a high-quality experience for women Person-centered approach to counseling is the preferred approach to achieve SDM. Demographic factors and women’s perceptions of their providers have been linked to decision-making. Literature is lacking on SDM practices in safety net clinics, particularly in local health departments. Exploring these constructs is important to inform practices and policies for family planning. This research aimed to examine: 1) the influence of sociodemographic factors on SDM; 2) the influence of SDM on contraceptive method choice; and 3) the effect that women’s perceptions of their providers might have on SDM and associated contraceptive method choice, among non-white women in South Carolina and Alabama. Secondary data were from a longitudinal study that surveyed women of reproductive age (16 to 44 years) from the two states. The data used for this research were collected from non-white women between October 2018 and September 2020 as part of a larger evaluation effort. Bivariate and multinomial analyses were conducted to assess associations and relationships. In Study 1, significant differences in SDM were observed for income and age, with younger women and lower income women having increased odds of engaging in SDM compared to older and higher income counterparts. In Study 2, multinomial analysis indicated that, compared to those who maintained autonomy over their decision, those whose decisions were shared and provider-driven had higher odds of choosing a short-acting method over a less effective method (OR = 1.608 and OR = 2.314, respectively). In Study 3, associations between SDM and women’s perceptions of providers were observed. Compared to those who maintained decision-making autonomy and had positive perceptions of providers, those who engaged in SDM and those whose decisions were least autonomous were more likely to choose a short-acting method over other, less effective contraceptive methods. There is need to further examine whether SDM is underutilized in these settings.

Symptom research with advanced lung cancer patients has primarily focused on symptom severity, frequency, and distress; yet, little is known about advanced lung cancer patients’ priorities and success criteria for symptom improvement. To address these gaps in the literature, this study examined these outcomes using a modified Patient Centered Outcomes Questionnaire (PCOQ), which has largely been used with adults with chronic pain. Advanced lung cancer patients (<i>N</i> = 102) were recruited from the Indiana University Simon Cancer Center to participate in a one-time self-report survey, including demographic and medical questionnaires, symptom treatment history, standardized measures of symptom severity and quality of life, and the modified PCOQ focused on eight common symptoms in advanced lung cancer. Cancer information was collected from medical records. My primary aim was to evaluate the construct validity of the PCOQ. As hypothesized, symptom severity ratings on the PCOQ were positively correlated with standardized assessments of the same symptoms as well as functional status. Greater severity of most symptoms on the PCOQ was also correlated with worse quality of life, and greater severity of four symptoms was correlated with having more medical comorbidities. Positive, moderate correlations were found between the severity and importance of seeing improvement in cough, fatigue, sleep problems, and pain on the PCOQ. Patients considered low levels of symptom severity to be acceptable following symptom treatment; no differences were found across the eight symptoms. Latent profile analysis identified four patient subgroups based on the importance of seeing improvement in each of the symptoms: (1) those who rated all symptoms as low in importance (<i>n</i> = 12); (2) those who rated bronchial symptoms and sleep problems as low in importance and all other symptoms as moderately important (<i>n</i> = 29); (3) those who rated nausea and emotional distress as low in importance and all other symptoms as moderately important (<i>n</i> = 23); and (4) those who rated all symptoms as highly important (<i>n</i> = 33). These subgroups were unrelated to demographic and clinical factors, except for functional status. Findings suggest that symptom severity and importance are related yet distinct aspects of the advanced lung cancer symptom experience. Furthermore, patients have heterogeneous priorities for symptom management, which has implications for tailoring treatment.

A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project guided by the patient-centered care model, needs based theory, and adult learning theory, was to test the impact of an educational module for nurses on best practices for teaching patients about medications. Thirty nurses consented to participate in the teach-back sessions. Results of the pre- and posttest, evaluating the nurses' knowledge and attitude about teach-back, were analyzed using the Wilcoxon Signed Ranks test and findings showed an improvement in knowledge scores (z = -2.833, p = .005). However, no statistically significant changes occurred in nurse attitudes toward teach-back. A comparison of descriptive HCAHPS scores on communication about medications and nurse communication showed that scores improved from a low of 58% top box to 74% after the teach-back education. These findings indicated that using teach-back could enhance communication about medications. Effectively communicating pertinent health information using teach-back may have significant consequences for nurse-patient-family engagement contributing to positive social change.

Introduction: Cardiovascular diseases (CVD) remain the leading cause of death in the United States (U.S.), accounting for one in three deaths annually. Within the U.S., disparities in CVD outcomes and risk factors exist across demographic groups and geographic areas, such as the Central Appalachian region where the burden is higher than state and national rates. Patient-centered care (PCC), is a model of health care delivery that has been shown to improves disease outcomes and quality of life, and is critical in addressing disparities in health care. However, little is known about how high-risk Central Appalachian populations understand or perceive such a model. As such, the objective of this study was to examine the perceptions of PCC among community-dwelling CVD patients/caregivers in the region. Methods: A qualitative study design applying thematic analysis was utilized for data collection and analysis. Seven focus group discussions across six states in Central Appalachia were conducted, and comprised of 78 middle-aged participants selected through purposive sampling. Sessions were guided by standardized instrument regarding current efforts in their communities concerning CVD; challenges and needs; appropriate approaches to their cardiovascular issues; understanding and views about patient-centeredness; and related priorities. The discussions were audio-recorded, transcribed, and then coded for thematic analysis using NVivo qualitative data analysis software. Dependability of data analysis was achieved through an audit trail tracking the NVivo process. Results: Data analysis identified interpersonal relationships with health care providers (HCPs) as the most important aspect of PCC among participants. When asked what PCC meant to them, each group discussed the interpersonal relationship they wanted from HCPs, barriers that kept them from achieving this relationship, and how it impacted their care. Within this theme, two overarching subthemes emerged: (1) developing long-term relationships with HCPs, and (2) developing partnerships with HCPs. The first theme had subthemes that included: turnover of HCPs in their geographical location, the disappearance of family physicians, and preferences related to seeing a physician versus a physician’s assistant or nurse practitioner. The second theme’s subthemes included: communication, feeling cared for as an individual, and input into care. Conclusion: Patients/caregivers stressed the importance of interpersonal relationships with providers in the delivery of PCC. However, patients recognized when PCC was not being provided, provided examples of interactions that were not conducive to providing PCC, and reported feeling disempowered as a person and a patient. The results of this research can be utilized to understand patient/caregiver perceptions of PCC, and indicates the need for further research to reconcile these viewpoints with those of providers to improve the delivery of care, and health outcomes.

Abstrakt Bakgrund: Empatitrötthet är ett relativt okänt begrepp som kan drabba sjukvårdspersonal och inte minst sjuksköterskor som oftast arbetar patientnära. Empatitrötthet har visat sig ge en negativ inverkan på den egna hälsan, privatlivet samt på förmågan att förse patienterna med en säker och personcentrerad omvårdnad. Syfte: Att beskriva sjuksköterskans erfarenheter av empatitrötthet. Metod: En litteraturöversikt enligt Fribergs metod baserad på sju kvalitativa artiklar och en mixad metod. Artiklarna är hämtade från databaserna Cinahl, Pubmed, Scopus, och PsycINFO. Även sekundära sökningar inkluderades. Resultat: Analysen resulterade i fyra huvudkategorier; En mödosam arbetsmiljö upplevs leda till empatitrötthet, olika tillkortakommanden som upplevs leda till empatitrötthet, upplevda negativa symtom och konsekvenser av empatitrötthet och hanteringsstrategier som upplevs minska eller motverka empatitrötthet Konklusion: Litteraturstudiens resultat visar på att sjuksköterskors empatitrötthet riskerar att inverka negativt på både privata och arbetsrelaterade plan samt kan påverka omvårdnadsförmågan och patientsäkerheten negativt. Empatitrötthet bör lyftas som begrepp och förklaras så att sjukvården blir mer medveten om vad tillståndet kan innebära samt hur det kan påverka omvårdnaden på ett negativt plan. Det är önskvärt att adekvata strategier appliceras för att minska och motverka empatitrötthet vid ett tidigt skede. / Abstract   Background: Compassion fatigue is a relatively unknown concept that can affect healthcare profession and in particular nurses that works close to the patients. Compassion fatigue has shown to have a negative impact on nurses well-being, the private life and the ability to perform a safe and person-centered care for the patients. Aim: To describe nurse's experience of compassion fatigue. Methods: A literature review according to Friberg's method based on seven qualitative studies and one mixed method. The studies were found using Cinahl, PubMed, Scopus and PsycINFO. Secondary searches were also included. Result: The analysis resulted in four main categories; an arduous work environment is perceived to lead to compassion fatigue, various shortcomings that are experienced lead to compassion fatigue, negative symptoms and consequences experienced by compassion fatigue and management strategies to counter or reduce the feeling of compassion fatigue. Conklusion: The results of the literature study show that the condition of compassion fatigue risks having a negative impact on both private and work-related levels among nurses and can negatively affect the ability of nursing and patient safety. Compassion fatigue should be highlighted as a concept and explained so that the health industry becomes more aware of what the condition may cause and and how it can affect nursing negatively. It is desirable that adequate strategies should be applied to reduce and counteract compassion fatigue at an early stage.